Monday, May 29, 2017

This year’s Memorial Day also happens to be the 100th Birthday of John F. Kennedy. Born May 29, 1917, he was the 35th president of the United States, and himself a WWII veteran of the Navy. A quick study, having learning from the Bay of Pigs debacle and negotiations with the then Soviet Union to get missiles out of Cuba, under pressure from Freedom Riders, Martin Luther King, Jr, and many others, Kennedy turned his attention to Civil Rights. It was only after his assassination in November 1963 that his successor Lyndon B. Johnson was able to get passed through Congress the Civil Rights Act of 1964 which outlawed discrimination based on race, color, religion, sex, or national origin. [We might remember today just what types of discrimination were outlawed.]

Memorial Day is a time to pause and remember those who died as soldiers, Marines, Airmen and women, sailors, Coast and National Guard persons. We thank them. Today might also, perhaps, be a time to recommit ourselves to giving back for their service by offering an hour a week pro bono psychotherapy to the family members, or veterans who remain, through, for example, Tampa Bay Institute for Psychoanalytic Studies’ Veterans Family Initiative. Many clinicians in the Tampa Bay area have generously given of their time and expertise to help families and wounded warriors afford much needed mental health services. We thank them as well.

Friday, May 26, 2017

Bromberg tells us that “the negotiation of selfhood and otherness...has a lot to do with imagination and creativity.” and that “The relative presence of “imagination” in human discourse overlaps to no small degree with the relative capacity for intersubjectivity that exists in any relationship.” [Being able to let in another’s experience allows for a “shared intersubjective space.”] Bromberg expands the shared space to include shared imagination, “loosen[ing] the rigidity” of one’s singular believes about the self [and other] to allow for a “relational unconscious.” I take this to mean if one is stuck in solipsistic fantasy, there is little to no room for interrelating with others much less comprehending that there exists another’s mind, one with separate contents from one’s own. He writes:

The cocreation of a lived, relational unconscious more and more nourishes the willingness of each person to participate in a growing sense of “We” that includes “Me” and “You” as part of their individually expanded self-experiences. By living together in the enacted shadow of what is visible but not perceived, an opportunity is afforded to encounter what has been hidden in plain sight. … This allows their relationship greater interpersonal spontaneity and creative self-expression that is carried by an expanded sense of selfhood into the world “out there.”

Relying on Winnicott’s 1971 paper on “Dreaming, Fantasying, and Living,” Bromberg elaborates that fantasy is a dissociated (‘Not me’) state while imagination embraces the ‘Me’. A colleague of mine noted that fantasy is somehow without hope [a remedy to hopelessness], while imagination includes hope about the future. Winnicott put it, in his enigmatically paradoxical way, like this: ”In fantasying, what happens, happens immediately, except that it does not happen at all.”

Bromberg explains:

For a person who is “imagining,” the state of affairs is different; the person is experiencing the self as it now exists, projected into the future. Because the self being imagined is the same self that is doing the imagining, the person as he is now has the capacity to act into a future that is real to him because the future that is imagined in the here-and-now is itself real. When the capacity to transform fantasy into imagination starts to increase, self-state transitions do not disrupt self-continuity, which in turn allows the present and the future to be bridged and thus to coexist. The person does not have to remain stuck in fantasy. What is imagined is not impossible for the self in the present; it just hasn't happened yet. [Einsteinian]

When the therapist can imagine, much like the mother for the infant, the patient’s expanding future on the horizon, then the patient, too, can consider such a future. The mother develops the mind of the infant by holding the infant in mind. The therapist develops the imagination of the patient by imagining.

Monday, May 22, 2017

A therapist discloses to a patient the dream she had about him the night of their previous session:

I was sitting next to you on the couch in my office. You were sitting in the middle of the couch and I was to your left. We were facing each other. I reached over and touched your face. Your skin was soft. You then reached over to me and I felt guilt and sadness. So I turned away crying, feeling that loss. I wondered if you felt I was rejecting of you. I turned back to you and you said, “I love your father.”

The therapist recognized the resurgence of familiar feelings: her love for her patient, the patient’s love for her, and how it could not be; also familiar feelings with the therapist’s father. The therapist knew she also loved her father, and he, her, and it could not be. So, said the therapist, I am in touch with my sadness.

The patient shares his dream:

I was in the backyard. There was a helicopter overhead. It started coming down, through the trees. I could see the pilot, we made eye contact, and waved, two men with white hair. Then the fence disappeared. Then it changed to the backyard of my childhood home and there were fields with no end.

The patient quipped [associated], Why can’t I dream about sex instead of about benevolent old men with white hair?

The therapist mused aloud, Maybe this is about your father, the unspoken lifelong wish that there were no longer barriers between the two of you, instead of your usual, professed indifference toward a preoccupied, distant and disdainful father.

The patient and therapist had long since past been in the throes of an erotic transference- countertransference. The patient, old enough to be the father of the female therapist, had, before therapy, used extra marital affairs to help him feel desired and competent. The female therapist had lost her own father when she but was a toddler. Now there was more honest, intimate relating between therapist and patient, able now to uphold boundaries without the presence of fences between them, and without the fear that boundary violations would occur. The patient, now able to talk about sexual desires without the urge to have to act on them. He no longer could accept hurting his wife with his infidelities.

Bromberg writes that the feelings stirred up in the therapist about the patient are not the personal property of the therapist, but belong to both.

The therapist, having understood about co-creation, no longer felt ashamed about her dream. She was able to feel the mutuality of her own father’s love. The patient said, “There is something so romantic about recognizing feelings that one can’t act on.” The therapist felt sadness, not romance.

Wednesday, May 3, 2017

The final semester at TBIPS for fourth year candidates and students includes an Electives course in which each candidate has the opportunity to teach the rest of the class about an area of interest chosen by the candidate. We are presently learning about the relationship between mothers and daughters and how not ‘good enough’ mothers can affect their daughters, daughters who later come to us for treatment. Those in the class with a Kleinian bent emphasize envy. We were discussing today Charles’ (2001) paper “Stealing Beauty” about how narcissistic mothers envy their children and cannot help them succeed, nor bear to see their children as separate subjects. Sometimes their envy is transformed into self sacrifice (a reaction formation).

I have my personal doubts about whether envy is innate and, instead, see it as a problem arising from failed early relationships. An interesting, more specific thought came up in class today when Bharat Bharat, an aspiring psychology student auditing the class, asked about whether envy is genetic and whether it is somehow linked to children in those delayed gratification studies (don’t eat the marshmallow now and get an extra one later) who may later grow up to want (enviously) what they do not have (and cannot manage to get due to problems with delayed gratification). Because I see children with poor impulse control as having a problem with self regulation, and problems with self regulation as a product of failed mutual regulation in early attachment relationships, I then wondered whether envy, if a problem with self regulation, stems from failure of early mutual regulation. Is failed mutual regulation (and, thus, insecure attachment) a mechanism for the development of envy?

If the caregiver, -- due to a history of trauma which now leads the caregiver to be preoccupied, dissociated, and unable to be with the child and with the child’s mind-- is unable to help the child feel attuned to and seen (unable to feel important enough), a child might feel deficient and defective, setting up a vulnerability for envy. This mechanism does not require envy of a good breast (but may include it), and, moreover, does not require gymnastic feats of imagination to explain envy, at least, to my mind.

Welcome!

Welcome to "Contemporary Psychoanalytic Musings," the blog of the Tampa Bay Institute for Psychoanalytic Studiesor, as it is conveniently known, T-BIPS. We invite you to post your comments on psychoanalysis and books, film, conferences, the media, art, theory, clinical situations, current controversies, social issues, and anything else as seen through a psychoanalytic lens. We look forward to a spirited dialogue with you.Lycia Alexander-Guerra, M.D.TBIPS PresidentGabcast! Welcome! #3

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About TBIPS

In 2005 a group of psychoanalysts & psychoanalytic psychotherapists convened to explore possibilities for meeting the educational needs of clinical professionals in the Tampa Bay area. Out of those discussions evolved a new institute, the Tampa Bay Institute for Psychoanalytic Studies. Consistent with the spirit of collegiality, openness, and diversity that inspired its development, the new Institute is non-authoritarian and democratic. Training programs utilize progressive and classical concepts which have been endorsed by contemporary critiques of psychoanalytic education. Believing that the capacity to think psychoanalytically best develops in an atmosphere of inquiry, open dialogue, and active participation the founding members sought to integrate these values into the structure of the new Institute and into the process of training. A precedent of collaboration and mutual respect for the contributions of all faculty and candidates was established enabling our mission to gain immediate representation in our actions.